Welcome ST1s in General Practice Tameside 2013

Aims and Intended Learning Outcomes

(ILOs)• AIM - to feel comfortable with and understand

- each other, the tutor and the course

• ILOs -

• We shall be able to enjoy and make the most of the diversity of backgrounds of folk who come into GP

• We will be able to start to think about and do some self directed learning

• We will have some ideas for making the most of hospital jobs

• We will know where the curriculum is and have some ideas for how to use it

What we are doing this morning

• Interview your partner and prepare to present your partner to the group

• Who are you? Names, where from, where trained?

• What brought you to GP?

• What special medical knowledge and skills do you have?

• What hobbies, interests and unusual skills do you have?

• Name a FEELING you have about being a GP

What we are going to do this year

•What do you WANT to achieve? (Hopes)

•What do you NEED to achieve? (Any fears)

•What would your trainers (educational supervisors) like you to achieve? (What do you need help with)

•What would I like us to achieve?

•HOW?!?!?!

Enjoying The ST1 Year

• What is an ideal GP?

• What is the opposite of an ideal GP?

• The curriculum

• What is self-directed learning?

• How to cope with hospital jobs?

• What do we need to do?

The GP Curriculum • COMPETENCIES

• Primary care management (clinical management, teams, IM&T)

• Person-centred care (consultation skills)

• Specific problem solving skills (data gathering,making diagnosis/decisions)

• A comprehensive approach (medical complexity)

• Community orientation

• A holistic approach

• ESSENTIAL FEATURES

• Contextual

• Attitudes (ethics and fitness to practice)

• Scientific (maintaining performance, learning and teaching)

Self directed learning

What is it?

What is Self Regulated Learning?

• An active process whereby learners set goals for their learning and monitor, regulate and control their cognition, motivation and behaviour.

(Pintrich 2002)

Performance Phase

Self-ControlImagery

Self-instructionAttention focussing

Task strategies

Self-ObservationSelf-recording

Self-experimentation

Self-Reflection Phase

Self-JudgmentSelf-evaluation

Causal attribution

Self-ReactionSelf-satisfaction/affect

Adaptive/defensive

Forethought Phase

Task AnalysisGoal setting

Strategic planning

Self-Motivation BeliefsSelf-efficacy

Outcome expectationsIntrinsic interest/value

Learning goal orientation

Classes of self-regulated learners

Self-regulatory phases Naïve self-regulators Skillful self-regulators

Forethought Nonspecific distal goalsPerformance goal orientationLow self-efficacyDisinterested

Specific hierarchical goalsLearning goal orientationHigh self-efficacyIntrinsically interested

Performance/Volitional control

Unfocused planSelf-handicapping strategiesOutcome self-monitoring

Focused on performanceSelf-instruction/imageryProcess self-monitoring

Self-reflection Avoid self-evaluationAbility attributionsNegative self-reactionsNonadaptive

Seek self-evaluationStrategy/practice attributionsPositive self-reactionsAdaptive

IN MY LEARNING I CAN GENERALLY:+++

++

+ - - -- - -

Set my own learning goals

Set my own process goals (i.e. determine what tasks/methods are required to achieve my goals)

Identify strategies for achieving my goals

Revise goals when necessary

Am motivated to learn

Can articulate what is expected of me

Document the processes I use when working on tasks

Monitor my progress towards achieving goals

Adjust my actions on my own to achieve goals

Modify or adapt strategies that are unsuccessful

Give constructive feedback to my peers

Constructively use feedback from my clinical supervisors

Constructively use feedback from the course facilitators

Constructively use feedback from my peers

Revise versions of my work to improve them

Reflect on my process of achieving my goals

Evaluate my own work

Know how I am being evaluated

Attribute my success to my efforts

Work well with other students

Have a learning goal orientation

Metacognitive Component Type Terminology

Cognitive knowledge

Knowledge about oneself as a learner and factors affecting

cognition

Person and task knowledge

Self-appraisal

Epistemological understanding

Declarative knowledge

Awareness and management of cognition, including

knowledge about strategies

Procedural knowledge

Strategy knowledge

Knowledge about why and when to use a given strategy

Conditionalknowledge

Cognitive regulation

Identification and selection of appropriate strategies and

allocation of resources

Planning

Attending to and being aware of comprehension and task

performance

Monitoring or regulating

Cognitive experiences

Assessing the processes and products of one’s learning, and revisiting and revising

learning goals

Evaluating

METACOGNITION

Typology of Metacognitive Components

Features of Self Regulated Learning(SRL)

• It is not a generic competency or a fixed ability

• It is not about learning in isolation

• All of us use self regulatory processes in our learning

• Skills of SRL can be learned and taught

• It is a context specific process

On our team

You are GPs now...

You are our spies....

• observers and participants

• observe their behaviour

• level of participation and reflection

• our ethos - where to find this?

Anthropological Study

• How do the other species behave?

• What animals could represent physicians, surgeons, paediatricians, psychiatrists, A and E, O and G,

Discipline and Learning Environment

• RULES OF ENGAGEMENT

• Phones?

• Eating?

• Being late?

• Wondering in and out?

• Openness and honesty?

• Respect and value all perspectives?

• Support and constructive criticism?

• Confidentiality? Anonymised or absolute?

• Preparation and commitment?

• Enjoyment?

• Expressing emotion?

• Attendance? Mandatory - need to email Sam!!!

• samantha.austin@tgh.nhs.uk

The course

• Have basic knowledge of subject of the month (NICE)

• Two Thursday mornings per month - one with expert and clinical focus and one with ST3 and actors for communication focus

• Start 9am. Half hour catch up time

• 9.30am Expert presentation on clinical subject in GP

• Including case discussion

• Lots of interaction!!!